Department of General Surgery, Rambam Health Care Campus, Haifa, Israel.
Department of General Surgery, Rambam Health Care Campus, Haifa, Israel, Department of Colorectal Surgery, Rambam Health Care Campus, Haifa, Israel.
Isr Med Assoc J. 2024 Aug;26(7):428-433.
Perianal abscess is a common condition among adults. The treatment of choice includes early and efficient drainage. The data regarding risk factors for abscess recurrence, fistula formation, and complications are limited as recent publications mainly focus on patients with inflammatory bowel disease.
To determine risk factors for abscess recurrence and fistula formation with regard to patient and surgical characteristics.
A retrospective analysis was performed on patients who presented to the emergency department and were diagnosed with perianal abscess between 2011-2020.
We included 983 consecutive patients; 741 men, average age 43 years. Recurrence was documented in 434 cases. Crohn's disease was reported in 70, of which 50 had recurrent episodes (P < 0.0001); 121 of the 234 patients who smoked had recurrence (P = 0.0078); 8% had short symptomatic period (< 24 hours), which was a predisposing factor for recurrence, P < 0.0001. Patients in the non-recurrent group waited 2.53 hours less for surgical intervention (P < 0.0005(. The average time for recurrent episode was 18.95 ± 33.7 months. Fistula was diagnosed in 16.9% of all cases, while 11.6% were within the recurrent group. Surgical expertise of the physician did not significantly change the recurrence rate.
Crohn's disease and smoking were the only significant risk factors for recurrence of perianal abscess. Timely intervention and drainage of sepsis should not be delayed. Involvement of more experienced surgeons did not seem to alter the natural history of the disease.
肛周脓肿是成年人常见的病症。治疗的选择包括早期和有效的引流。关于脓肿复发、瘘管形成和并发症的风险因素的数据有限，因为最近的出版物主要关注炎症性肠病患者。
确定与患者和手术特征相关的脓肿复发和瘘管形成的风险因素。
对 2011 年至 2020 年间在急诊科就诊并被诊断为肛周脓肿的患者进行回顾性分析。
我们纳入了 983 例连续患者；741 例男性，平均年龄 43 岁。434 例患者记录有复发。报告有克罗恩病 70 例，其中 50 例有复发（P < 0.0001）；234 例吸烟患者中有 121 例复发（P = 0.0078）；8%的患者症状持续时间较短（< 24 小时），这是复发的一个诱发因素，P < 0.0001。无复发组患者等待手术干预的时间少了 2.53 小时（P < 0.0005）。复发的平均时间为 18.95 ± 33.7 个月。所有病例中诊断出瘘管 16.9%，而在复发组中为 11.6%。医生的手术专业知识并没有显著改变复发率。
克罗恩病和吸烟是肛周脓肿复发的唯一显著危险因素。不应延迟对脓毒症的及时干预和引流。经验丰富的外科医生的参与似乎并没有改变疾病的自然病程。
